Technology in Long and Short Term Care Nursing Communities

studioSIX5 Blog 2

8/22/2011

By Dean Maddalena, AIA, NCARB, President 

               It probably comes as no surprise that technology has had steady growth in medical records, charting, and on the care giving side, with most communities already upgrading or planning to in the near future. A more unexpected impact of technology, though, is with the residents and their families.

               Short term stay residents expect a hospitality environment with healthcare rehab services. A nursing community with a great reputation and a sterile environment will lose out to the community with a great reputation and a hospitality environment. And communities not only have to impress potential residents and their families, but also the physician networks who recommend communities to their patients. Would they want to recuperate there?

               People over 60 are now the fastest-growing users of social networking. This means that residents and their families will expect the presence of wireless networks throughout communities to access their Internet. This will encourage multi-generational visits with access to Internet socializing and games for interaction. And the residents themselves can enjoy additional benefits, such as computer games (Wii, etc.) for physical as well as cognitive exercise. Residents enjoy these games so much that they have tournaments that encourage social interaction with other residents, caregivers and family. There are also computer programs for resident wellness education.

               Long-term care residents enjoy the same things, but there are additional programs for them, such as “legacy” programs where they can document their life with words, pictures, stories, facts, family history, and so forth. This brings joy to their daily routine to create these legacies, knowing they will pass them on to their families.

               There are also mental exercise computer games, such as Little Shop of Treasures, in which players have to find hidden items that are in plain sight, or computerized jigsaw puzzles. There are also computer-based, brain-training games, such as math quizzes or matching games like Mahjong. Most interesting of all are programs such as Dakim BrainFitness (http://www.dakim.com), which was designed specifically for seniors. The program combines trivia games with memory-challenging games and constantly adjusts itself to remain challenging to individuals using the software. It addresses six cognitive areas: language, critical thinking, short-term memory, long-term memory, computation and visuospatial orientation. The company states that its system, which includes a full touchscreen computer, is now being used in some 420 communities nationwide.

               And with the rise of smartphones and the somewhat larger tablet computers, there are likely to be a whole new generation of apps for seniors—not only for games, videos and large-type reading, but also apps that will provide ways for caregivers to follow up with clients after a visit, or for families to more easily communicate with residents between visits. We are just at the beginning of this revolution. Better care and more active and engaged seniors are sure to result from these developments.

What Role Do Children Play in Choosing a Senior Living Community?

                 As I began thinking about this topic, I remembered the case of a son in his 50s trying to help his father, a man in his mid-80s, who had been the caregiver for his 80-year-old wife who was suffering from late-stage Alzheimer’s. The parents lived in a suburban environment. The son, who lived in a city 500 miles away, had taken a week off from work to help his father, who had just realized he was no longer physically able to continue to care for his wife, choose a skilled nursing community for her.

                Together they toured several different communities in the area. The husband was determined to remain in his home as long as he possibly could, so he was uninterested in moving to a CCRC community where he could be near his wife. The communities they toured varied enormously in terms of amenities, age of the facilities, and cost structures. The son tended to favor newer communities, or those with the most amenities. In the end, the community they chose was chosen by the husband’s most important criteria: proximity to his home—it was only about a mile from his house. He still drives, but the community was also on the bus route, so if he became unable to drive, he could still visit his wife twice a day. The community wasn’t the nicest, or the cheapest, or the most expensive. It was not a memory care community. In fact, it was a bit dated and in need of renovation. It was simply the closest. As they say in real estate, location, location, location.

                Had the husband not still been living, the wife would probably have ended up in another community—perhaps in another state—because the role of the “caregiver” would have shifted to the children. And the children will most likely look for those tangible things we all think about—location, newness or reputation of the community, the quality of the staff, the cheerfulness of the environment and the amenities/services it offers—and don’t forget about the quality of the food service and the security the community offers.  In many cases where the parent is a surviving spouse, s/he will participate in these decisions, which may involve choosing a CCRC with a cheerful environment close enough to the child with responsibility for care to make regular and frequent (we hope) visits. In other cases, it may be left to the child alone to make the decision, and with the guilt many children feel when placing their parents in these communities, you can bet they will choose on the basis of cheerful, pleasant environments, quality of staff, amenities, food quality, security and ease of access (for the child, not the parent, and statistically, this child is a 55-year-old first-born daughter). Most importantly, the child will ask herself, “Would I want to live there?”

                So when designing new or updated senior living communities, it’s worthwhile for marketability to realize that there are a couple of different generations you’re trying to appeal to, and their motivations for making their ultimate decisions vary by generation. But the key thing is that this is typically the first time the family (parent and children) learn of senior living options. And this is a chance to sell two generations on your community. The (adult) child has to be wowed for future decisions in his/her own life.